小剂量多巴胺联合多巴酚丁胺治疗小儿重症肺炎的临床效果观察

Clinical effect of low dose dopamine combined with dobutamine in the treatment of severe pneumonia in children

目的探讨小剂量多巴胺联合多巴酚丁胺治疗小儿重症肺炎的临床效果。方法本研究选取2017年3月-2019年3月沈阳市某医院收治的100例重症肺炎患儿作为研究对象,采用随机数字表法将患儿分为研究组与对照组,每组50例。对照组患儿接受常规治疗,研究组患儿在对照组患儿治疗基础上接受小剂量多巴胺联合多巴酚丁胺治疗。比较2组患儿治疗前后白细胞介素-6(IL-6)、白细胞介素-8(IL-8)及C反应蛋白(CRP)水平;比较2组患儿治疗前后呼吸峰值流速(PEF)、剩余50%潮气量时呼气流速(TEF50%)、达峰时间比(TPEF/TE);比较2组患儿临床疗效。结果研究组患儿治疗总有效率为94.0%,高于对照组的76.0%,差异有统计学意义(P<0.05)。治疗后,研究组患儿IL-6,IL-8及CRP水平分别为(52.99±7.82)pg/mL,(19.87±3.14)pg/mL及(12.37±2.98)mg/L,低于对照组的(73.87±8.35)pg/mL,(28.72±3.67)pg/mL及(23.02±6.37)mg/L,差异均有统计学意义(P<0.05)。治疗后,研究组患儿PEF及TEF50%分别为(70.38±4.27)mL/s及(69.42±3.35)mL/s,均低于对照组的(78.09±5.42)mL/s及(76.03±3.89)mL/s,差异均有统计学意义(P<0.05)。治疗后,研究组患儿TPEF/TE为26.64±3.87,大于对照组的21.32±3.38,差异有统计学意义(P<0.05)。结论在常规治疗的基础上加用小剂量多巴胺、多巴酚丁胺治疗小儿重症肺炎,能够取得更加理想的临床效果,可有效调节患儿的血清炎症细胞因子水平,促进患儿肺功能的恢复,该方案可作为今后临床治疗小儿重症肺炎的一种推荐用药方案。

Objective To explore the effect of low dose dopamine combined with dobutamine in the treatment of severe pneumonia in children.Methods One hundred children with severe pneumonia in a hospital in Shenyang from March 2017 to March 2019 were selected as the study objects,The children were divided into study group and control group,50 cases in each group.Control group received routine treatment,The children in the study group received low-dose dopamine combined with dobutamine on the basis of the control group.The levels of IL-6,IL-8 and CRP were compared before and after treatment;Before and after treatment,PEF,TEF50%and TPEF/TE were compared between the two groups;The clinical effects of the two groups were compared.Results The total effective rate of the study group was 94.0%,higher than 76.0%of the control group,The difference was statistically significant(P<0.05).After treatment,The levels of IL-6,IL-8 and CRP in the study group were(52.99±7.82)pg/mL(19.87±3.14)pg/mL and(12.37±2.98)mg/L,which were lower than those in the control group(73.87±8.35)pg/ml,(28.72±3.67)pg/mL and(23.02±6.37)mg/L,The difference was statistically significant(P<0.05).After treatment,PEF and TEF50%in the study group were(70.38±4.27)mL/s and(69.42±3.35)mL/s respectively,which were lower than those in the control group(78.09±5.42)mL/s and(76.03±3.89)mL/s,The difference was statistically significant(P<0.05).After treatment,TPEF/TE in the study group was(26.64±3.87),which was higher than that in the control group(21.32±3.38),The difference was statistically significant(P<0.05).Conclusions On the basis of routine treatment,The treatment of severe pneumonia in children with low dose dopamine and dobutamine can achieve ideal results,It can effectively regulate the level of serum inflammatory factors in children,Promote the recovery of children′s lung function,It can be recommended for the treatment of severe pneumonia in children.